Pendle Brook Care Home

Pendle Brook Care Home is a care home without nursing care, providing accommodation for persons who require personal care for up to 50 people. The service provides support to adults and older people and people living with dementia. At the time of our inspection there were 29 people using the service. The care home can accommodate people across three floors in one building, however at the time of our inspection, only two floors were being used.

People’s experience of using this service and what we found

Medicines and risks relating to people's health and safety were not always being appropriately managed. Staffing levels were adequate and recruitment practices were robust. Safeguarding practices were in place; staff knew what to report and people living at the home told us they felt safe. Good infection prevention control practices were being followed and people were receiving visitors. Accidents were recorded and lessons were learned.

People's needs were not always fully assessed, and people's care plans did not always detail necessary information. Staff were supported through supervisions, though staff training was not fully up to date. We have made a recommendation about staff training. Feedback on meals indicated improvements were needed. Although the home was purpose built, the environment could be improved for people living with dementia. Oral healthcare plans were in place and the home was registered with a dental hygienist. The service worked in partnership with a variety of health care professionals.

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. Although the policies and systems in the service supported this practice and necessary DoLS referrals were being made, best interest decisions were not always in place. We made a recommendation the provider ensures they follow best interests’ guidance.

People's equality, diversity and dignity was respected. The service used an electronic care plan system to record people’s details on. People and their relatives were able to express their views. Surveys were being completed to gather feedback and people were able to access advocacy if required.

Records relating to people’s care were not always person centred, but people were able to make everyday choices. There was a complaints policy and procedure in place and a complaints log was being maintained. At the time of the inspection no one was in receipt of end of life care. People’s communication needs were being met. An activities coordinator was employed by the provider who led on a variety of activities for people living in the home.

Quality assurance systems needed further improvement. Various documents were either not completed, not in place, not up-to date or not accurate and audits carried out by the manager did not always identify the issues we found at this inspection. Staff were aware of how to report poor practice and there was a procedure in place to support this. Feedback about the manager was positive. The manager reported necessary incidents to appropriate organisations and lessons were learned. Meetings for staff and people that use the service were taking place, and relatives were kept up to date via telephone, email and through social media. Surveys were available for staff, people and their relatives to complete.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (3 November 2021). The service remains rated requires improvement. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that provider reviews, their processes to ensure safe recruitment practices are always followed. At this inspection we found the provider had acted on this recommendation and improvements had been made.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report. The provider is working in making improvements in the areas we have identified.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pendle Brook Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risk, medication and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We have met with the provider to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Pendle Brook Care Home is a residential care home providing accommodation and personal care for up to 50 people. The service does not provide nursing care. At the time of the inspection, there were 28 people living in the home, most of whom were living with dementia.

Pendle Brook Care Home is a purpose-built home with special consideration given to the needs of people living with dementia. The home is located in the town of Oswaldtwistle. Accommodation is provided over three floors. At the time of the inspection, only the top two floors of the building were being used to accommodate people.

People’s experience of using this service and what we found

People living in the home told us they felt safe and that staff treated them well. Relatives told us there were effective systems in place to keep people safe, particularly when they had experienced falls in the home.

The provider had systems in place to monitor the quality and safety of the service. However, these had not been effective as we identified a number of shortfalls during the inspection. The provider had failed to ensure important checks had been regularly completed; these included checks relating to fire safety and the environment. Care records did not always show that people had received the care and support they needed. We have also made a recommendation in relation to recruitment processes.

Staff had received training in safeguarding and knew what action to take to protect people from the risk of harm. We were generally assured regarding the measures in place to protect people from the risk of infection, including COVID-19. People told us the home was kept clean. Relatives told us systems were in place to enable them to safely visit family members in the home. Some staff had not received training in how to put on and dispose of personal protective equipment (PPE). In addition, the provider needed to ensure all visitors to the home, including staff employed at their other locations, completed the documentation they had in place in relation to testing and any exposure to COVID-19,

Although the provider had experienced staffing issues, this had not had a negative impact on the care people received. The provider told us they were in the process of recruiting to the vacant posts. People received their medicines as prescribed.

Staff told us they enjoyed working in the home and were committed to ensuring people received high quality care. They told us the management team were supportive and approachable.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 9 July 2021).

Why we inspected

The inspection was prompted in part due to concerns received about staffing, recruitment and infection control. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

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You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pendle Brook Care Home on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We identified breaches in relation to the lack of regular checks of the safety of the environment and the lack of effective systems to monitor the quality and safety of the service.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Pendle Brook Care Home is a residential care home providing personal care and support for up to 50 people, most of who were living with dementia. The service does not provide nursing care. At the time of the inspection, there were 28 people living in the home.

Pendle Brook Care Home is a purpose-built home with special consideration given to the needs of people living with dementia. The home is located in the town of Oswaldtwistle. Accommodation is provided over three floors.

People’s experience of using this service and what we found

People told us they felt safe and were happy with the service they received. They said staff were kind and caring and they were treated well. Staff understood how to protect people from abuse and recruitment processes ensured new staff were suitable. There were enough staff to meet people's needs and to ensure their safety; additional staff were being recruited. People received their medicines when they needed them from staff who had been trained and had their competency checked. Risk assessments enabled people to retain their independence and receive support with minimum risk to themselves or others. Infection control was well managed, and the home was clean and free from hazards.

People's care and support needs were assessed prior to them using the service to ensure their needs could be met. They were supported to live healthy lives and had access to health and social care professionals, a well-trained staff team and a choice of a nutritious diet. The home worked in partnership with other organisations to provide effective and consistent care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The environment had been developed with people’s specialised needs in mind.

Management and staff had developed friendly, caring and respectful relationships with people and their families. People were treated as individuals which helped protect their dignity. People's equality and diversity was respected by a caring staff team. Staff understood the importance of giving people their time and knew the importance of encouraging people to maintain their independence.

People's care was tailored to their needs, routines and preferences and staff knew people well. People had access to a range of organised activities. Safe visiting processes were in place to ensure people could see their visitors when they wished and could maintain relationships that were important to them. People spoken with, did not have any complaints about the service but were confident to raise any issues.

People were happy with the way the service was managed and staff felt valued and enjoyed working at the home. There were effective systems to assess and monitor the quality of the service and the practice of staff and appropriate action was taken when shortfalls were noted. People's views and opinions of the service were sought and acted on.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 23 May 2019, and this is the first ratings inspection.

On 19 January 2021, we carried out a targeted inspection to follow up on specific concerns about staffing, infection prevention control measures and people's dietary requirements.

The Care Quality Commission (CQC) have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. A rating was not given at that time as we did not assess all areas of a key question.

Why we inspected

This was a planned inspection to provide a rating under the Care Act 2014.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Pendle Brook Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Pendle Brook is a residential care home providing accommodation for up to 50 adults, who require assistance with personal care needs. The home accommodates people across three floors. A number of people living in the home were living with dementia. The service was supporting 28 people at the time of the inspection.

People’s experience of using this service and what we found

We looked at infection prevention and control (IPC) measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively. During the inspection, we had some concerns about IPC processes that required action to ensure risks were minimised. Processes to manage infection control were not as effective as needed to be in the circumstances of a national pandemic. Despite this, the home was clean and tidy.

People were supported appropriately and the service let us know about events with people when there was a statutory obligation to do so. When we looked at some of these, we noted some really good practices but in one case, lessons had not been learned and there was a risk of an issue being repeated. The service put the situation right by the end of the inspection.

Recruitment processes were robust and there were enough suitably trained and supported staff to care and support people. We saw staff engaged with people and treating them with kindness, respect and compassion. We saw some good interactions with those who lived at the home and people were assisted in an appropriate manner.

People said they enjoyed their meals. We observed a lunch time sitting and noted people were eating high quality food, there was plentiful supply and there was choice. People were encouraged appropriately and there was a light hearted atmosphere in the dining room.

Rating at last inspection

The service had not been inspected previously.

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in response to concerns received about staffing, infection prevention control measures and people's dietary requirements . A decision was made for us to inspect and examine those risks.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question. We found no evidence during this inspection that people were at risk of harm from these concerns.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.